Healthcare Provider Details
I. General information
NPI: 1154515492
Provider Name (Legal Business Name): LOW VISION RESOURCE CENTER-DBA VIEWFINDER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/29/2007
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1830 S ALMA SCHOOL RD SUITE 131
MESA AZ
85210-3056
US
IV. Provider business mailing address
1830 S ALMA SCHOOL RD SUITE 131
MESA AZ
85210-3056
US
V. Phone/Fax
- Phone: 480-924-8755
- Fax: 480-854-1864
- Phone: 480-924-8755
- Fax: 480-854-1864
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152WL0500X |
| Taxonomy | Low Vision Rehabilitation Optometrist |
| License Number | 1378 |
| License Number State | AZ |
VIII. Authorized Official
Name: MR.
KEVIN
MICHAEL
HUFF
Title or Position: OWNER
Credential: O.D.
Phone: 480-924-8755